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NPI Code Detail

MEDICARE: MADELEINE LEDERER OTR/L

MEDICARE: MADELEINE LEDERER OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist4223785OR

General Provider Information

NPI Number : 1629847868
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELEINE LEDERER OTR/L
Provider Business Mailing Address
First Line : 4741 LARKSPUR CIR
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-3354
Country : US
Telephone Number : 920-358-4424
Fax Number :
Provider Business Practice Location Address
First Line : 2999 OLYMPUS BLVD
Second Line :
City : COPPELL
State : TX
Zip : 75019-0122
Country : US
Telephone Number : 469-524-1506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2023
Last Update Date : 12/28/2023

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Directions to “ MADELEINE LEDERER OTR/L” Practice Location

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